HouseCalls-Online Blog

Online Documentation Course

I have just published my Power Point based online documentation course for skilled home health care. Check it out at kathyquan.teachable.com


New to Home Health Book

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Are you new to home health care? Or thinking about transitioning your career? 

My lateset book Exploring the Home Health Experience: A Guide to Transitioning Your Career Path can help you make this a smooth transition. 

I have compiled my 35+ years of mentoring new staff to home care into a compact guide to help you understand the basics and the background for cumbersome items such as the OASIS. 

Exloring the Home Health Care Experience is available in paperback and Kindle formats from Amazon. 

Home Health Documentation Conference

On August 19, 2015 form 2:00-3:15 EDT, Kathy Quan, founder Housecalls-Online.com will be presenting an audio conference for C4CM.com on home health documentation. The conference will focus on improving patient care and avoiding reimbursement denials through better documentation. Early Bird registration is open now and through August 5 you can save 20%. 

Course Highlights: 

This comprehensive program covers: 

  • Why effective documentation practices matter to care and cost
  • Examples of what effective documentation looks like
  • A review of policies governing reimbursement of home health services and practical steps to help achieve payment for these services
  • Important standards and principles of home care documentation
  • Pros and cons of electronic documentation
  • Examples of appropriate documentation relative to the coverage criteria under CMS
  • A review of HH PPS final rule (79 FR 66032) documentation requirements

You’ll also learn best practice strategies and tips to: 

  • Minimize legal risks, 
  • Develop foolproof auditing and documentation systems, and 
  • Motivate nurses and clinicians to document completely and accurately.

CMS Issues New Homebound MUSTs

Defining homebound status is something CMS has left as vague for many years. Recently the Office of the Inspector General (OIG) requested that CMS be more specific about what is required for a patient to be considered “homebound.”

CMS has finally responded using the term "confined to the home":

In order for a patient to be considered confined to the home, BOTH of the following criteria must be met:

1. The individual has a condition due to an illness or injury that restricts his or her ability to leave their place of residence except with the aid of supportive devices such as crutches, canes, wheelchairs, and walkers; the use of special transportation; or the assistance of another person; or if leaving home is medically contraindicated.

2. The condition of the patient should be such that there exists a normal inability to leave home and, consequently, leaving the home would require a considerable and taxing effort.

This ruling becomes effective November 19,2013.

Resources:

CMS: http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM8444.pdf

FREE Webinar on 2013 PPS Rule

Attention Home Health and Hospice agencies: Healthcare First is offering a FREE Webinar (“2013 PPS Proposed Rule: What it Says and What it Could Mean for Your Agency,) on Aug. 9 at 10:30 AM Central Time. 

2013 PPS Rates, Hospice Quality Reporting, and Survey Info in Federal Register Now

On July 13, the 2013 PPS rates, hospice quality reporting requirements, and survey and enforcement requirements were posted in the Federal Register.   

OIG Report Released

The OIG released their report entitled Limited Oversight of Home Health Agency OASIS Data. It contains some interesting facts including:

  • 6% of 2009 claims are missing-- representing $1 Billion in Medicare payments. Is this an indication of fraud? 
  • 15% of OASIS data sets were submitted late.
  • CMS failed to meet key responsibilities.

The OIG has thoughts and recommendations for penalties to be imposed. 

Download and read the entire report here.


VNAA Supports 2013 FY Budget; Opposes Co-Pay for Home Health

In a statement released last week (2/13/12), the VNAA announced its support of President Barak Obama's efforts to cut waste and abuse in the Medicare and Medicaid systems. In his proposed 2013 FY budget, President Obama proposes efforts "to boost integrity and reduce improper payments."

The VNAA does however, oppose the proposal in the 2013 FY budget to impose a $100 co-pay for Medicare home health and hospice services. According to Andy Carter, VNAA President and CEO, "we urge Congress and the Administration to avoid across-the-board cuts or patient co-payments. And instead use targeted strategies to reduce payments, as the President's budget states [made to the wrong person, in the wrong amount, or for the wrong reason.]"

For more information read more….

Scrubs in Home Care

There has always been a debate in home health care about uniforms vs. wearing street clothes for safety measures as well as ease of care. One of the biggest arguments against street clothes is enforcing a professional look or dress code. Remember, you represent your company when you go out to see your patients. You also represent yourself as a professional. 

In making home visits, there is also the personal factor. Some of the homes you visit are less than ideal. How many times have you experienced the need to go straight home and shower for an hour, scouring every inch of your body before you can stop itching or imagining things crawling all over you?!! We've all been there-- or will have been there before your home care career is over.

Scrubs offer a great option. They are professional and yet commonplace enough not to draw undue attention to you in the community as you get to your patient's homes. They can be laundered in strong detergents and hot water, and unlike your nice personal attire, not be ruined. 

Support Home Health Care Legislation

Home Health Care Planning Improvement companion bills have been introduced in both the US House of Representatives and the US Senate to bring Medicare into the 21st century and allow APRNs (NPs, CNS, and Nurse Midwives) as well a Physician Assistants (PAs) to certify patients for home health care and to sign the Plan of Care as well as supplemental orders. 

Please take a moment to write to your Senators and Representatives asking them to support these bills. HR2267 was introduced in the House by Representatives Allyson Schwartz (D-PA) and Greg Walden (R-OR). The Senate bill (S227) was introduced by Senators Susan Collins (R-ME) and Kent Conrad (D-ND). 

The American Nurses Association has made it simple to email or send snail mail to your Congressional reps with a canned email message that you can edit if you you prefer and send directly from the ANA site. 

Read more about the bills at Nurse.com.


Sponsored by Kendall College's Early Childhood Education Degree


Join us on FACEBOOK

We have set up a new page on FACEBOOK for home health professionals. LIKE the page and then start or join in a discussion to network with other home health professionals.  

Thanks

Kathy

Happy Nurse Day and Nurses Week

Happy Nurse Day and Nurses Week


From Kathy Quan and TheNursingSite.com

Sponsored by Keiser University's Online Nursing Degree


Why is Health Care Going Home?

Here's an interesting commentary from the New England Journal of Medicine about why home health care will be exploding in the future of health care. 

Sponsored by The Chicago School's Masters Degree in Psychology

Why Health Care is Going Home


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